PDF(Pubmed)
Abstract：
BACKGROUND: Individuals with migraine frequently experience pre- and post-headache symptoms. This analysis aimed to characterize the relative frequency and burden of pre- and post-headache symptoms in people with migraine using data collected through the Chronic Migraine Epidemiology and Outcomes - International Study.
METHODS: This cross-sectional, observational, web-based survey was conducted in 2021-2022 in Canada, France, Germany, Japan, the United Kingdom, and the United States. Respondents who met modified International Classification of Headache Disorders, 3rd edition, criteria were offered the opportunity to participate. Information collected included migraine-related disability, depression/anxiety symptoms, cutaneous allodynia, activity limitations, and acute treatment optimization. Respondents indicated how often they had pre- or post-headache symptoms using a 5-point scale, ranging from 0 to 4, with a rating of 2 or higher classified as a pre- or post-headache symptom case. Modeling was used to examine relationships with monthly headache days (MHDs) and activity limitations during pre-headache and post-headache phases.
RESULTS: Among a total of 14,492 respondents, pre-headache symptoms were reported by 66.9%, while post-headache symptoms were reported by 60.2%. Both pre-headache and post-headache symptoms were reported by 49.5% of respondents, only pre-headache by 17.4%, only post-headache by 10.7%, and neither pre- nor post-headache symptoms by 22.4%. Compared with respondents who experienced only pre- or post-headache symptoms, respondents who experienced both pre- and post-headache symptoms had the highest rates of 4-7, 8-14, and ≥ 15 monthly headache days (23.1%, 14.1%, and 10.9%, respectively). Of respondents with both pre- and post-headache symptoms, 58.5% reported moderate-to-severe disability, 47.7% reported clinically significant symptoms of depression, 49.0% reported clinically significant symptoms of anxiety, and 63.8% reported cutaneous allodynia with headache (ASC-12). Moderate-to-severe activity limitations were reported during the pre-headache (29.5%) and post-headache phases (27.2%). For all outcomes modeled, after controlling for covariates, having pre-headache symptoms, post-headache symptoms, or both were associated with worse outcomes than having neither.
CONCLUSIONS: Pre- and post-headache phases of migraine are common, carry unrecognized burden, and may be a target for treatment.
METHODS: This cross-sectional, observational, web-based survey was conducted in 2021-2022 in Canada, France, Germany, Japan, the United Kingdom, and the United States. Respondents who met modified International Classification of Headache Disorders, 3rd edition, criteria were offered the opportunity to participate. Information collected included migraine-related disability, depression/anxiety symptoms, cutaneous allodynia, activity limitations, and acute treatment optimization. Respondents indicated how often they had pre- or post-headache symptoms using a 5-point scale, ranging from 0 to 4, with a rating of 2 or higher classified as a pre- or post-headache symptom case. Modeling was used to examine relationships with monthly headache days (MHDs) and activity limitations during pre-headache and post-headache phases.
RESULTS: Among a total of 14,492 respondents, pre-headache symptoms were reported by 66.9%, while post-headache symptoms were reported by 60.2%. Both pre-headache and post-headache symptoms were reported by 49.5% of respondents, only pre-headache by 17.4%, only post-headache by 10.7%, and neither pre- nor post-headache symptoms by 22.4%. Compared with respondents who experienced only pre- or post-headache symptoms, respondents who experienced both pre- and post-headache symptoms had the highest rates of 4-7, 8-14, and ≥ 15 monthly headache days (23.1%, 14.1%, and 10.9%, respectively). Of respondents with both pre- and post-headache symptoms, 58.5% reported moderate-to-severe disability, 47.7% reported clinically significant symptoms of depression, 49.0% reported clinically significant symptoms of anxiety, and 63.8% reported cutaneous allodynia with headache (ASC-12). Moderate-to-severe activity limitations were reported during the pre-headache (29.5%) and post-headache phases (27.2%). For all outcomes modeled, after controlling for covariates, having pre-headache symptoms, post-headache symptoms, or both were associated with worse outcomes than having neither.
CONCLUSIONS: Pre- and post-headache phases of migraine are common, carry unrecognized burden, and may be a target for treatment.
摘要：
背景：偏头痛患者经常会出现头痛前后的症状。该分析旨在使用通过慢性偏头痛流行病学和结果-国际研究收集的数据来表征偏头痛患者头痛前后症状的相对频率和负担。
方法：这个横截面，观察,基于网络的调查于2021-2022年在加拿大进行，法国,德国,Japan,联合王国,和美国。符合修订后的国际头痛疾病分类的受访者，第3版,标准提供了参与的机会。收集的信息包括偏头痛相关的残疾，抑郁/焦虑症状,皮肤异常性疼痛,活动限制，和急性治疗优化。受访者使用5点量表指出他们在头痛之前或之后出现头痛症状的频率，范围从0到4，等级为2或更高，被归类为头痛前或后症状病例。使用建模来检查头痛前和头痛后阶段与每月头痛天数（MHD）和活动限制的关系。
结果：在14,492名受访者中，头痛前症状报告为66.9%，而头痛后症状报告为60.2%。49.5%的受访者报告头痛前和头痛后症状,只有17.4%的人头痛前，仅头痛后下降10.7%，头痛前后症状均无22.4%。与仅在头痛之前或之后出现过症状的受访者相比，同时出现头痛前后症状的受访者的每月头痛天数为4-7、8-14和≥15天（23.1％，14.1%,10.9%，分别)。在有头痛前后症状的受访者中，58.5%报告中度至重度残疾，47.7％的人报告了临床上明显的抑郁症状，49.0％的人报告了临床上明显的焦虑症状，63.8%报告皮肤异常性疼痛伴头痛(ASC-12)。在头痛前阶段（29.5％）和头痛后阶段（27.2％）报告了中度至重度活动限制。对于所有建模的结果，在控制协变量后，有头痛前的症状，头痛后的症状，或者两者都与比两者都没有更糟糕的结果相关。
结论：偏头痛的头痛前和头痛后阶段很常见，携带无法识别的负担，并且可能是治疗的目标。
方法：这个横截面，观察,基于网络的调查于2021-2022年在加拿大进行，法国,德国,Japan,联合王国,和美国。符合修订后的国际头痛疾病分类的受访者，第3版,标准提供了参与的机会。收集的信息包括偏头痛相关的残疾，抑郁/焦虑症状,皮肤异常性疼痛,活动限制，和急性治疗优化。受访者使用5点量表指出他们在头痛之前或之后出现头痛症状的频率，范围从0到4，等级为2或更高，被归类为头痛前或后症状病例。使用建模来检查头痛前和头痛后阶段与每月头痛天数（MHD）和活动限制的关系。
结果：在14,492名受访者中，头痛前症状报告为66.9%，而头痛后症状报告为60.2%。49.5%的受访者报告头痛前和头痛后症状,只有17.4%的人头痛前，仅头痛后下降10.7%，头痛前后症状均无22.4%。与仅在头痛之前或之后出现过症状的受访者相比，同时出现头痛前后症状的受访者的每月头痛天数为4-7、8-14和≥15天（23.1％，14.1%,10.9%，分别)。在有头痛前后症状的受访者中，58.5%报告中度至重度残疾，47.7％的人报告了临床上明显的抑郁症状，49.0％的人报告了临床上明显的焦虑症状，63.8%报告皮肤异常性疼痛伴头痛(ASC-12)。在头痛前阶段（29.5％）和头痛后阶段（27.2％）报告了中度至重度活动限制。对于所有建模的结果，在控制协变量后，有头痛前的症状，头痛后的症状，或者两者都与比两者都没有更糟糕的结果相关。
结论：偏头痛的头痛前和头痛后阶段很常见，携带无法识别的负担，并且可能是治疗的目标。
